2022年臺灣中部某職場結核病聚集事件之職業安全防治

Occupational Safety and Prevention following a Workplace Tuberculosis Cluster, Central Taiwan, 2022

臺灣中部某公司於2022年4月至7月發現2名員工確診結核病，且經基因型比對結果為同基因型別，確認為一起結核病之聚集事件。經調查發現，2名個案互為指標個案及職場接觸者關係。案一就醫通報前即出現體重減輕及久咳未癒情形，經公司管理者建議後就醫，就醫時即屬高傳染力結核病。案二於接受接觸者檢查時的胸部X光未發現有結核病灶，待終止有效暴露日滿8週後進行丙型干擾素釋放試驗為陽性，檢驗陽性轉介評估發現胸部X光異常結果。環境調查發現個案的工作場所位於一樓，環境換氣不良。防治措施包括於作業場所加裝排氣裝置及規劃通風導管，並建議該公司建立追蹤管理員工健檢機制。經介入後至2023年7月止，該事件發生單位未再有新診斷結核病個案。

From April to July 2022, two employees at a company in central Taiwan were diagnosed with tuberculosis. Mycobacterium tuberculosis isolates from both cases shared the same genotype, as confirmed by mycobacterial interspersed repetitive units analysis (MIRU).
The index case sought medical treatment as recommended by the company manager, presenting symptoms of weight loss and a persistent cough for months prior to the tuberculosis diagnosis. The second case had direct contact with the index case at the workplace. Although no tuberculosis lesions were found on chest X-ray during the initial contact examination, 8 weeks after terminating effective exposure, his interferon-gamma release assay (IGRA) was positive. Tuberculosis was diagnosed by chest X-ray and sputum culture.
Environmental investigation found poor ventilation at the workplace, which was located on the ground floor. We recommended the installation of industrial exhaust systems and a redesign of ventilation ducts connecting to rooftop exhaust equipment. We also recommended that the company establish a mechanism to track and manage employee health examinations.
After these interventions were implemented, by July 2023, this company reported no new cases of tuberculosis.